By  | May 27, 2013 |  0
This large single center study found 29% of patients wanted to participate in medical decision making, which was more likely in those highly educated and with private insurance. This preference was associated with a longer LOS (0.26 days) and higher cost ($865). This is the first study to link preference with medical decision making and […]
By  | May 27, 2013 |  14
I sometimes explain to medical students that they are entering a profession being transformed, like coal to diamonds, under the pressure of a new mandate. “The world is going to push us, relentlessly and without mercy, to deliver the highest quality, safest, most satisfying care at the lowest cost,” I’ll say gravely, trying to get […]
By  | May 25, 2013 |  0
This trial found no difference in patient outcomes (mortality or LOS) if admitted during a time of 24/7 intensivist coverage, or during a time with only daytime intensivist coverage (with home call at night) in a medical ICU. This study does not show a patient benefit to a 24/7 intensivist staffing model in an academic […]
By  | May 25, 2013 |  0
This trial of patients with severe ARDS randomized them to prone (at least 16 hours a day) or supine positioning. Those in the prone position had significantly lower 28 day mortality (16% vs 33%), and 90 day mortality (24% vs 41%) with no difference in complications (abstract).
By  | May 25, 2013 |  0
This study of patients intubated in the ICU randomized them to patient-initiated/directed music, noise canceling headsets, or usual care. Those in the music group had significantly lower anxiety scores and use of sedatives compared to usual care. Those in the music group also had lower sedation frequency (but not sedation intensity or anxiety scores) compared […]
By  | May 25, 2013 |  0
This trial of patients with acute COPD exacerbation were randomized to 5 versus 14 days of steroids and found no difference between the groups in time to next exacerbation (abstract).